Body member tourniquet

ABSTRACT

A body member tourniquet for use in surgical procedures where it is desired to limit or restrict flow through a body vessel or to secure a tube within such vessel. The tourniquet consists of an elongate flexible tube having a rigid head at one end. The tube is looped about a vessel and the free end positioned in a passage in the head and drawn about the vessel, the head holding the tube about the vessel. A second passage is provided for additional security in locking the tube against movement relative to the head.

United States Patent Talonn Oct. 7, 1975 1 BODY MEMBER TOURNIQUET3,409,014 11/1968 Shannon 128/326 [75] Inventor: Daniel A. Talonn,University City, FOREIGN PATENTS OR APPLICATIONS 235,628 1925 UnitedKingdom 128/327 [73] Assignee: Sherwood Medical Industries Inc.,

St. Louis, Mo. Primary Examiner-Richard A. Gaudet Filed: June 1974Assistant Exammer-R1ck Op1tz Appl. No.: 481,576

US. Cl 128/327; 24/130 Attorney, Agent, or Firm-Stanley N. Garber;William R. OMeara [57] ABSTRACT A body member tourniquet for use insurgical procedures where it is desired to limit or restrict flowthrough a body vessel or to secure a tube within such vessel. Thetourniquet consists of an elongate flexible tube having a rigid head atone end. The tube is looped about a vessel and the free end positionedin a passage in the head and drawn about the vessel, the head holdingthe tube about the vessel. A second passage is provided for additionalsecurity in locking the tube against movement relative to the head.

6 Claims, 4 Drawing Figures Oct. 7,1975

U.S. Patent BODY MEMBER TOURNIQUET BACKGROUND OF THE INVENTION Thisinvention relates to a tourniquet for a body member, and moreparticularly to a disposable device of this nature which substantiallyreduces the clutter normally occurring, for example, in the surgicalfield during certain operative procedures, while permitting rapid,non-traumatic application.

During certain surgical procedures, it is necessary to either constricta body vessel or insert a catheter or other medical tube into the lumenof a body vessel. For example, in open-heart surgery it is necessary toprovide an artificial means whereby the breathing functions of the lungsand pumping functions of the heart can be assured during the period thatthe heart is open. Thus, the heart and lungs must be bypassed bydiverting the venous blood returning from the body to the right atriuminto a heart-lung machine and pumping the blood oxygenated by themachine back into the aorta, either through one of its branches orthrough the aorta itself. For this purpose, vena caval catheters areinserted into the superior and inferior vena cavae. In the past, it hasbeen common practice to prevent leakage of blood past the catheteropening by encircling the vessel with a snare or tourniquet to tightenthe vessel around the inserted catheter. For example, a cord shod may beused, the latter consisting of a rubber tube through which a length ofumbilical tape is passed after encircling the vessel. Once the tape ispassed through the tube, an external clamp such as a hemostat is appliedto the tube to secure the tape in position therein.-

The use of such prior art clamping devices provide considerable clutterin the operative field mainly due to the clamp used to secure theumbilical tape within the rubber tube. In certain operative procedures,a relatively large number of such devices must be used, thereby undulylimiting the surgeons access to the operative site.

Examples of vascular toumiquets which have been designed tooverco'methese and other problems in the use of conventional devices areillustrated in US. Pat. Nos. 3,043,308 and 3,507,270.'-As will bereadily observed, however, the devices illustrated by these patents arerelatively expensive to manufacture, and lack the simplicity and ease ofuse which characterize the presentinvention. An improved tourniquet ofthe type including a rubber tube through which a length of umbilicaltape is passed is shown and described in application Ser. No. 441,702,filed Feb. 11, 1974, now US. Pat. No; 3,877,434, for Vascular Tourniquetand as- SUMMARY OF THE INVENTION Accordingly, among the several objectsof the present invention may be noted the'provision of a body membertourniquet which substantially reduces clutter in the operative field;the provision of such a device which easilyand quickly applied about abody member or vessel to either restrict the same or secure a tubeorcatheter therein; the provision of such a device which causes little orno trauma to the body membe'ryand the provision of such a device whichis characterized bylow cost for disposal after use with a singlepatient.

In general, abody member tourniquet constructedin accordance withthe'present invention comprises an elongate member having a smooth,rounded outer surface formed of a soft, flexible material. A rigid headis secured to one end of the elongate member, the head providing apassage for receiving the other end of the elongate member after it isdisposed about the body member, the passage restricting movement of theelongate member relative to the head to secure the elongate member aboutthe body member.

These and other objects and features will be apparent hereinafter.

BRIEF DESCRIPTION OF THE DRAWINGS DESCRIPTION OF THE PREFERREDEMBODIMENT Referring now to the drawings, and particularly to FIG. 1,the present body vessel tourniquet is indicated generally at 10. Whilethe tourniquet will be illustrated and described for use in securing acatheter within a body vessel, such as a vein or artery, it should beunder-v stood that the invention also can be used for restricting avessel, such as a blood vessel, urinary tract duct,or other body member.

The tourniquet 10 comprises an elongate flexible member shown as a tube12 formed of a soft plastic material such as, for example, polyvinylchloride. The tubing may, for example, be approximately 8 inches inlength and may be provided in various diameters depending upon theparticular application. A preferred tube outer diameter for use ingeneral surgery has been found to be within a range between'aboutone-eighth to one-fourth of an inch, for example, approximately 0.144inch. As illustrated, the free end 14 of tube 12 is blunt, although abeveled or pointed end may be provided as described more fullyhereinafter.

A relatively rigid head member 16 is secured to the opposite end of tube12 by means of an integral projection 18 extending angularly from thehead, as seen in FIGS; 2 and 3. The tube 12 is telescoped overprojection 18 and is solvent or adhesively bonded thereon.

The head is of generally rectangular, flat configuration and may beformed, for example, by injection molding a suitable plastic material,such as, for exam- -ple, relatively hard polyvinyl chloride,polycarbonate,

or polyethylene. As will be noted in FIGS. 2 and 3, a passage, indicatedgenerally at 20, extends through the head 16 near its distal end. Thepassage 20 consists of a circular hole or aperture 22 and an entranceslot 24 extending from the hole 22 and opening at the distal edge 26 ofthe head. Hole 22 is slightly smaller in diameter than the outerdiameter of tube 12 so that the tube 12 is constricted when it isinserted into the hole. Similarly, the width of slot 24 is smaller thanthe outer diameter of tube 12.

The opposite or proximal end of head 16 is similarly provided with apassage 28 extending therethrough and consisting of a hole or aperture30 opening to the proximal edge 32 of the head via a slot 34. Thediameter of hole 30 and Width of slot 34 are also slightly less than thediameter of tube 12. As best illustrated in FTG. 3, the passages 20 and28 extend completely through head 16 from its upper surface 36 to itslower surface 38. As also shown in FIG. 1, the lower face 38 of the headis provided with a pair of ribs 40 at its proximal end and a rib 42 atits distal end. The rib 42 extends only over a portion of the lowersurface of the head due to the interruption caused by passage 20, whilethe ribs 40 extend across the head but are interrupted in the middle bypassage 28.

As set forth above, the diameter of holes or apertures 22 and 30 areslightly smaller than the outer diameter of the tube 12. Preferably, therelative size of the hole and tube are such that the tube is onlyslightly larger than the hole so that frictional resistance to passageof the tube through the hole is not so great as to prevent the tube frombeing readily manually pulled through the hole or excessively compressedby the hole. For example, for a tube having an outer diameter of 0.144or 0.145 inch, the apertures or holes 22 and 30 may have a diameter ofapproximately 0.140 inch. The width of each of the slots 24 and 34, asviewed in FIG. 2, is substantially less than the diameter of the holes22 and 30 and the tube 12 and expecially where the slot joins the hole.For example, each of the slots 24 and 34 may have a width that allowsthe tube to be moved through it but in a compressed or deformedcondition. As seen in FIG. 3, hole 22 is provided with relatively sharpupper and lower proximal edges 44 and 46, and hole 30 has an upperdistal edge 48 which is relatively sharp to secure the tube againstmovement, as will be described more fully hereinafter.

The use of the tourniquet will now be described in connection withsecuring a body vessel 50 about a medical tube or catheter 52, asillustrated in FIG. 4. In use, after catheter 52 is inserted into thevessel 50, the tube 12 is looped about the vessel and the distal end ofthe tube is pressed into hole 22 through slot 24. For example, with theend 14 about or proximally of the head 16, the side wall of the tube isreadily pushed first into the slot 24 and then into hole 22. Thelongitudinal axis of the tube can be parallel to the axis of hole 22during this insertion. The tube 12 is then tightened about the vessel 50for holding the catheter 52 therein and preventing blood flow around itby sliding the head 16 downwardly over the tube 12 to urge the vesselagainst the catheter with a desired force. In this position, it will benoted that the rib 42 extends radially downwardly at the distal end ofhead 16 and presses against the vessel 50 thereby tending to fill thespace between the vessel and the tourniquet where the tube passesthrough passage 20 and this tends to apply pressure all around thevessel and avoid any pinching of tissue. The tube is held againstmovement relative to the head primarily by edge 46 of aperture 22 whichfrictionally binds against the outer surface of the tube, althoughretention is also obtained or aided by frictional engagement with thewalls of the aperture.

To insure against slippage of the tube in aperture 22, a second lockingmeans is provided by passage 28 so that the tube can be extendedproximally over the upper face 36 of the head from hole 22 and passedthrough slot 34 into aperture 30, thereby eliminating any chance ofslippage. As seen in FIG. 4, the tube 12 extends around the vessel 50upwardly through hole 22, across the upper surface 36, and downwardlythrough hole 30. The tube 12 may be slightly stretched when it isinserted into slot 34 and hole 30. Since the hole 30 and slot 34 aresomewhat narrower than tube 12, the tube cannot pop out of hole 30 andstraighten out. The edge 48 and side walls of hole 30 frictionallyengage the tube to retain it against movement in hole 30.

The elongate member 12 is preferably circular in cross-section in itsnormal or untensioned condition and compressible in a radial directionso that when applied under tension to a body member, such as in FIG. 4,it becomes slightly flattened or oval. This has the effects ofincreasing the area of contact and more evenly distributing the pressureon the body member. Also, the elongate member 12 may roll or be appliedwith an axial twist without any edges causing concentrated pressuresagainst the vessel. When the elongate member 12 is tubular or hollow,the radial compression and the above desirable effects are enhancedbecause of the ease with which it tends to flatten or become compressed.It should be noted that the projection 18 is arcuate so that it conformsgenerally to the average size vessel or body member with which it is tobe used. The projection 18 is also flat or of general oval configurationin cross-section so that the portion of the tube 12 which receives theprojection will generally conform to the major portion of the tube whenapplied to a body member.

To release the tourniquet, the free end of the tube 12 is grasped andforced upwardly out of aperture 30 through slot 34. The head 16 is thengrasped and moved upwardly away from the vessel 50, ribs 40 providing anon-slick surface for grasping by the user, and the tube is removed fromthe primary aperture 22 through its associated slot 24.

As previously indicated, the present tourniquet reduces trauma to thebody vessel by providing a smooth tube which encircles the vessel. Thetube 12 has no sharp edge to injure the vessel and is slightly elasticand stretchable, and is slidable over the vessel surface so that itexerts uniform pressure over the entire contacting surface of thevessel. The tourniquet is also formed of a unitary assembly and does notrequire any other components for its operation.

As described above, the tube is locked within the passage 20 primarilyby friction of the tube against the sharp edge 46 of aperture 22,although friction of the tube against the wall of the aperture alsotends to retain the tube against movement relative to the head. Thislocking effect is aided by the fact that when the tourniquet 10 istensioned about the vessel as in FIG. 4, the vertical axis of hole 22 orproximal wall of the hole is generally radial or chordwise of the vessel52 and causes the tube 12 to severely bend around edge 46 reducing thechance of slippage. The axis of hole 22 is maintained generally radiallyor chordwise of the vessel by forming the head 16 such that theprojection 18 is generally arcuate or angularly related to the main bodyportion of the head or to the axis of hole 22. With the shown projection18 arcuate, and the axis of the hole generally radial relative to thearc of the projection 18, the arcuate projection and edge 46 of hole 22are urged toward the vessel as seen in FIG. 4 to bend the tube severelyand lock it against slippage.

While the passage 20 may be adequate to retain the tube againstmovement, the second passage 28 provides additional assurance againstmovement of the tube relative to the head. It should be understood thatwhile the passages and 28 are illustrated as comprising a hole and slot,the slot may be eliminated although this will require threading of thedistal end of the tube 12 through the hole and is slightly lessconvenient than moving the tube through a slot and into a hole. Whenusing the latter construction, the distal end 14 of the tube may beprovided with a tapered or pointed end to facilitate threading throughthe hole. Also, a hook, loop, ring or labyrinth passage could beprovided on the upper surface 36 of head 16 to provide a passage forlocking the tube against movement rather than the apertures 22 and 30.

In view of the above, it will be seen that the several objects of theinvention are achieved and other advantageous results obtained.

As various changes could be made in the above construction withoutdeparting from the scope of the invention, it is intended that allmatter contained in the above description or shown in the accompanyingdrawings shall be interpreted as illustrative and not in a limitingsense.

What is claimed is:

l. A body member tourniquet comprising an elongate member having asmooth, rounded outer surface formed of a soft, flexible material, and arelatively rigid head including a relatively flat main portion havingopposed ends and opposed sides, and a projection connected to one ofsaid ends and extending generally angularly relative to the upper andlower faces of said main portion, one end of said elongate member beingsecured to said projection, said main portion having a pair of holesextending therethrough between the upper and lower faces thereof withthe holes spaced from each other and each of said opposed ends andopposed sides and with one of said holes closer to said one end than theother of said holes, and entrance slot means extending through said mainportion from the periphery thererof to each of said holes to allowinsertion of the side walls of said elongate member through saidentrance slot means and into one of said holes after said elongatemember has been placed about a body member, the diameter of each of saidholes being less than the width of said elongate member and greater thanthe width of said entrance slot means.

2. The body member tourniquet of claim 1 wherein said slot meanscomprises a first slot connecting said one hole to the periphery of saidhead, and a second slot connecting the other of said holes to theperiphery of said head.

3. The body member tourniquet of claim 1 wherein said elongate member isa tube of soft, elastic plastic, said one end of said elongate memberbeing bonded to said projection.

4. The body member tourniquet of claim 2 wherein said head includes arib extending downwardly from the lower face of said head adjacent saidone end thereof and is engageable with a body member when the bodymember is encircled by the body member tourniquet.

5. The body member tourniquet of claim 1 wherein said projection is anarcuate integral part of said head, said head is of relatively hardplastic, and said elongate member is a tube of relatively soft plastic.

6. The body member tourniquet of claim 5 wherein said tube is circularin cross-section and comprises soft,

1. A body member tourniquet comprising an elongate member having asmooth, rounded outer surface formed of a soft, flexible material, and arelatively rigid head including a relatively flat main portion havingopposed ends and opposed sides, and a projection connected to one ofsaid ends and extending generally angularly relative to the upper andlower faces of said main portion, one end of said elongate member beingsecured to said projection, said main portion having a pair of holesextending therethrough between the upper and lower faces thereof withthe holes spaced from each other and each of said opposed ends andopposed sides and with one of said holes closer to said one end than theother of said holes, and entrance slot means extending through said mainportion from the periphery thererof to each of said holes to allowinsertion of the side walls of said elongate member through saidentrance slot means and into one of said holes after said elongatemember has been placed about a body member, the diameter of each of saidholes being less than the width of said elongate member and greater thanthe width of said entrance slot means.
 2. The body member tourniquet ofclaim 1 wherein said slot means comprises a first slot connecting saidone hole to the periphery of said head, and a second slot connecting theother of said holes to the periphery of said head.
 3. The body membertourniquet of claim 1 wherein said elongate member is a tube of soft,elastic plastic, said one end of said elongate member being bonded tosaid projection.
 4. The body member tourniquet of claim 2 wherein saidhead includes a rib extending downwardly from the lower face of saidhead adjacent said one end thereof and is engageable with a body memberwhen the body member is encircled by the body member tourniquet.
 5. Thebody member tourniquet of claim 1 wherein said projection is an arcuateintegral part of said head, said head is of relatively hard plastic, andsaid elongate member is a tube of relatively soft plastic.
 6. The bodymember tourniquet of claim 5 wherein said tube is circular incross-section and comprises soft, elastic polyvinyl chloride.